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Pentostatin (Nipent®)

OncoLink Team

Last Modified:
July 30, 2015

Pronounced:PEN-toe-stah-tin

Classification:Purine Analog

About Pentostatin (Nipent®)

Pentostatin is a purine analog, which is a type of antimetabolite. It inhibits the enzyme adenosine deaminase, interfering with the cell's ability to make and replicate DNA. DNA is critical to cell division and growth. Since cancer cells generally divide more often than healthy cells, medicationss that target DNA-related processes are more toxic to cancer cells than healthy cells.

How to Take Pentostatin

Pentostatin is given by intravenous (IV, into a vein) infusion. The dosage and schedule is determined by the person’s size and type of cancer. Intravenous fluids will be administered prior to and after the infusion of pentostatin. Pentostatin is infused over a few minutes to up to 30 minutes.

Possible Side Effects of Pentostatin

There are a number of things you can do to manage the side effects of pentostatin. Talk to your doctor or nurse about these recommendations. They can help you decide what will work best for you. These are some of the most common side effects:

Low White Blood Cell Count (Leukopenia or Neutropenia)

White blood cells (WBC) are important for fighting infection. While receiving treatment, your WBC count can drop, putting you at a higher risk of getting an infection. You should let your doctor or nurse know right away if you have a fever (temperature greater than 100.4), sore throat or cold, shortness of breath, cough, burning with urination, or a sore that doesn't heal.

Tips to preventing infection:

Washing hands, both yours and your visitors, is the best way to prevent the spread of infection.

Avoid large crowds and people who are sick (i.e.: those who have a cold, fever or cough or live with someone with these symptoms).

When working in your yard, wear protective clothing including long pants and gloves.

Ask your doctor or nurse before you, or someone you live with, has any vaccinations.

Low Red Blood Cell Count (Anemia)

Your red blood cells are responsible for carrying oxygen to the tissues in your body. When the red cell count is low, you may feel tired or weak. You should let your doctor or nurse know if you experience any shortness of breath, difficulty breathing or pain in your chest. If the count gets too low, you may receive a blood transfusion.

Low Platelet Count (Thrombocytopenia)

Platelets help your blood clot, so when the count is low you are at a higher risk of bleeding. Let your doctor or nurse know if you have any excess bruising or bleeding, including nose bleeds, bleeding gums or blood in your urine or stool. If the platelet count becomes too low, you may receive a transfusion of platelets.

Do not use a razor (an electric razor is fine).

Avoid contact sports and activities that can result in injury or bleeding.

Do not take aspirin (salicylic acid), non-steroidal, anti-inflammatory medications (NSAIDs) such as Motrin®, Aleve®, Advil®, etc. as these can all increase the risk of bleeding. Unless your healthcare team tells you otherwise, you may take acetaminophen (Tylenol).

Do not floss or use toothpicks and use a soft-bristle toothbrush to brush your teeth.

Nausea and/or Vomiting

Talk to your doctor or nurse so they can prescribe medications to help you manage nausea and vomiting. In addition, dietary changes may help. Avoid things that may worsen the symptoms, such as heavy or greasy/fatty, spicy or acidic foods (lemons, tomatoes, oranges). Try antacids, (e.g. milk of magnesia, calcium tablets such as Tums), saltines, or ginger ale to lessen symptoms.

Call your doctor or nurse if you are unable to keep fluids down for more than 12 hours or if you feel lightheaded or dizzy at any time.

Rash

This medication can cause a rash, which can become severe with continued use of the medication. Let your healthcare team know if you develop a rash or other skin changes. Your skin may also become dry. You should use a moisturizer on your skin and lips, but avoid moisturizers with perfumes or scents. Your doctor or nurse can recommend medication if itching is bothersome. If your skin does crack or bleed, be sure to keep the area clean to avoid infection.

Decrease in Appetite

Nutrition is an important part of your care. Cancer treatment can affect your appetite and, in some cases, the side effects of treatment can make eating difficult. Ask your nurse about nutritional counseling services at your treatment center to help with food choices.

Try to eat five or six small meals or snacks throughout the day, instead of 3 larger meals.

If you are not eating enough, nutritional supplements may help.

You may experience a metallic taste or find that food has no taste at all. You may dislike foods or beverages that you liked before receiving cancer treatment. These symptoms can last for several months or longer after treatment ends.

Avoid any food that you think smells or tastes bad. If red meat is a problem, eat chicken, turkey, eggs, dairy products and fish without a strong smell. Sometimes cold food has less of an odor.

Add extra flavor to meat or fish by marinating it in sweet juices, sweet and sour sauce or dressings. Use seasonings like basil, oregano or rosemary to add flavor. Bacon, ham and onion can add flavor to vegetables.

Fatigue

Fatigue is very common during cancer treatment and is an overwhelming feeling of exhaustion that is not usually relieved by rest. While on cancer treatment, and for a period after, you may need to adjust your schedule to manage fatigue. Plan times to rest during the day and conserve energy for more important activities. Exercise can help combat fatigue; a simple daily walk with a friend can help. Talk to your healthcare team for helpful tips on dealing with this side effect.

Other Side Effects

Be sure to let your healthcare provider know if you experience any of these, less common, side effects:

Eyes can become dry, watery or sensitive to sunlight.

Pain or ringing in the ears, loss of hearing.

This medication can affect kidney function, so you should drink plenty of fluids before and after each treatment to help your kidneys flush out the medication.

Some patients will have an allergic reaction to this medication. Notify your nurse right away if you experience any difficulty breathing, itching, chills, fever, or dizziness. You will be monitored during the infusion.

This medication can affect your liver function. If you develop any jaundice (yellowing of the skin or eyes), abdominal pain or easy bruising, notify your healthcare team.

Reproductive Concerns

Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Effective birth control is necessary during treatment. Even if your menstrual cycle stops or you believe you are not producing sperm, you could still be fertile and conceive. You should consult with your healthcare team before breastfeeding while taking this medication.